Accommodation and Near Vision with Crystalens Compared to Monofocal Intraocular Lens in Cataract Patients

1. Michael Goggin¹
2. Sacha Moore¹
3. Douglas Parker¹
4. Katherine Zamora-Alejo¹
5. Katja Ullrich¹

¹The Queen Elizabeth Hospital, Woodville South, Australia

Purpose: To evaluate objective accommodation measurements between patients bilaterally implanted with a newer generation accommodating intraocular lens (IOL) compared to a monofocal IOL.

Methods: Patients with bilateral cataracts underwent cataract surgery and received an accommodating IOL (Crystalens HD). These eyes were compared to a matched group, receiving a monofocal IOL (Akreos MI60, Acri.Tec 46LC, Acrysof SN60WF). Pre-operative and post-operative best corrected distance, intermediate and near vision were evaluated. Post-operative dynamic refraction was measured using the Grand Seiko WAM-5500 Binocular Autorefractor/Keratometer.

Results: Twenty eyes from 10 patients (mean age: 69 +11; range 51-84 years) were implanted with the Crystalens HD. Eighteen eyes from 9 patients (mean age: 69 + 9; range: 52-77 years) were included in the monofocal IOL group. Nine eyes were implanted with the Akreos MI60, 8 with the Acri.Tec 46LC and 1 with the Acrysof SN60WF. Post-operative distance corrected near visual acuity was significantly better in the accommodating IOL group compared to the monofocal IOL group (p = 0.01). The WAM-5500-measured spherical equivalent suggested greater accommodation in the first group (0.02 + 47) compared to the second group (0.45 + 52) at a distance of 40 cm (p = 0.01).

Conclusion: Accommodating IOLs provide better best corrected near vision acuity and may provide a degree of accommodation in patients compared to monofocal IOLs.